Latest NFL-NFLPA joint review of Tua Tagovailoa concussion exposes flaws in system

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On the surface, the NFL and NFL Players Association exonerated the Dolphins and league employees ostensibly responsible for spotting possible concussions and ordering concussion evaluations.

At a deeper level, the decision that everything was handled properly exposes real flaws in the overall process, because it’s undeniable that: (1) Tua Tagovailoa suffered a concussion; and (2) he kept playing after suffering a concussion.

Those two factors set the stage for a potentially serious health outcome. It happens several times per year at the high-school level. Second impact syndrome. A second brain injury immediately after a first brain injury. Swelling of the brain that goes out of control and can be fatal.

If the system created by the league and the union for spotting potential concussions worked properly last Sunday, the system created by the league and the union for spotting potential concussions doesn’t properly work. Because a player with one concussion was continuously exposed to a second one.

The biggest flaw, as one source with knowledge of the overall process explained it on Saturday, continues to be the unwillingness of many players to not self-report a potential concussion. That happens for various reasons.

First, the player’s brain is potentially impaired. He may not even realize he’s having symptoms.

Second, very few players are comfortable with the idea of tapping out voluntarily. Remember when Ben Roethlisberger did it and everyone said, “The culture has changed!” It hasn’t. Some players have the luxury to raise a hand and say, “I may need to exit the game.” Most players worry that they may be Wally Pipping themselves.

For Tua, who already has become far more closely identified with head trauma that he wants to be, it’s even less likely that he’d voluntarily add another coat to the scarlet letter on his helmet.

So what can be done, beyond more aggressive training and urging of players to speak up when they think they may have been concussed? As it relates to players who have had at least one documented concussion in a given season, perhaps a different standard should apply regarding when a concussion evaluation will happen.

The current protocol mandates an evaluation when a player strikes his head and there is associated injury behavior. For a player like Tua, who previously suffered at least one and possibly (probably) two concussions this year when his head struck the turf, maybe the approach should have been that any time he strikes his head on the turf, he gets a sideline evaluation.

And maybe the broader approach should be that players will have individualized protocols based on their own specific histories. For some players, the spotters would watch for a blow to the head and associated behavior. For others, like Tua, a forcible blow to the head would be enough for a quick check, at a minimum.

Does that place too much of a burden on the professionals monitoring the game? If it does, get more. If two aren’t enough, get three. If there aren’t enough, get four. And so on.

If NFL players are going to be treated like patients, the league and the union should have the capacity in place to help ensure that every player-patient receives proper care and attention. While the player absolutely has an obligation to help himself, the league and the union need to recognize that many won’t, requiring extra steps to protect players against the potential development of second impact syndrome.

13 responses to “Latest NFL-NFLPA joint review of Tua Tagovailoa concussion exposes flaws in system

  1. Also shows Mike McDaniels situational awareness for his players safety…but he’s sure aware of the dangers of snowballs

  2. The league knows that way too many fans do not care about the players health and safety. We see it here all of the time in comments like “they get a paid a lot to take these risks”. It is disappointing that so many people are willing to sacrifice other humans purely for those people’s entertainment.

  3. Good article. More spotters with increased attention will likely lead to more key players pulled out per game. To compensate, this should mean larger rosters and larger game-day active rosters, which could lessen the pressure for a player to stay in. Teams could then take the time necessary to develop that fourth quarterback or seventh receiver and give their current starters a much needed rest at a critical time. This would also reduce the incentive for headhunting to remove a key player.

  4. Unfortunately, concussions are a mysterious, invisible injury that we understand very little about. I took a rear-impact hit to my head last year on a Monday morning at the gym, drove home, worked all day and felt just fine. It wasn’t until Tuesday afternoon/Wednesday morning, that I felt like something was off, got checked out for a concussion, and that Sunday was in the ER getting a CT scan to make sure I didn’t have a brain bleed. Long story short, you can be concussed and not exhibit symptoms for sometimes hours or even days. This case with Tua looks to be one where he didn’t instantaneously exhibit neuroligical dysfunction after putting him through the testing process, and so they sent him back out there. Tua needs to seriously rethink his playing career while he’s young. 2 concussions back to back are no joke.

  5. While it’s “undeniable” that Tua was diagnosed with a concussion a day after the game, it doesn’t mean that he would have been diagnosed on Sunday if he had been examined. That is “undeniably” not how concussions work. Many do not surface until days later.

  6. The concussion protocol is going to be renamed the tua protocol after this season

  7. The very nature of a concussion injury makes it impossible to identify it alone by observation of the game. A player can have an impact on his body other then the head area and have a secondary impact within his skull causing a brain injury. All players may need to have an examination on the sideline in addition to the observers especially if they have had a concussion history.

  8. Tua might can learn from Roger Staubach, who retired for this very reason. Maybe that would help make it slightly more palatable, though Tua is nowhere near as accomplished or even legendary. Either way, I wish him the best.

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